In General Knowledge for the Family, Physical & Mental Health

What You Need to Know About Manic Depression

According to British comedian, actor and author Stephen Fry, a producer told him a secret about making it big in Hollywood. “You don’t need to be gay or Jewish to get on here, just bipolar.” Fry realized that the producer really meant “larger than life”, but he always remembered that bit of advice because he suffered from bipolar disorder, also called manic depression.

Fry is one of the many bipolar patients who are not only functional, but successful. However, being bipolar is not something that equals instant fame and fortune. Many bipolar patients find life so unbearable that they commit suicide. In his award-winning documentary The Secret Life of the Manic Depressive (2006) one doctor tells Fry that about half of everyone with bipolar disorder never seeks help. It is only by seeking help can this condition be managed.

Manic Depressive Disorder

Manic depressive disorder is characterized by periods or cycles of mania and depression. Mania almost always precedes depression. Every bipolar patient experiences these cycles in different ways. One patient may cycle every few months while another may cycle every few years. Another patient may cycle constantly for the rest of his or her life.

It is only by exhibiting the symptoms of cycling that a person can be diagnosed as having bipolar disorder. Many mental health professionals are only comfortable diagnosing someone with bipolarity if they have gone through at least two cycles in their lives. This means that many people with manic depression go for years without treatment because of the problems of diagnosis.

The Manic Cycle

It is nearly impossible to get a manic patient treatment because they feel on top of the world. Actress, writer and bipolar patient Carrie Fisher describes being manic as “better than any drug.” Some symptoms include:

  • Not needing sleep.
  • Excessive money spending.
  • Increase in risk-taking behaviors, such as experimenting with drugs or having unprotected sex.
  • Having grandiose ideas.
  • Moving rapidly from one thought or idea to another.

Some people go to frightening extremes while they are manic. These behaviors include manic depressive psychosis, hearing voices and jumping off of roofs because they are convinced that they can fly. Some people are able to work incredibly long and productive hours while manic. Some become quite destructive.

The Depressive Cycle

The depressive cycle is the polar opposite of mania. It hits all the harder because the patient has just had incredibly blissful feelings. Depressive symptoms are similar to those of major depression, except that the feelings eventually go away – provided the patient survives them. The late distinguished actor Jeremy Brett (1933 – 1995) would become so depressed that he would experience manic depressive psychosis and become catatonic. He would stare at a wall for days at a time, never realizing that the telephone would ring, the mail would pile up at his door or even be aware of people knocking on his door.

Common signs of depression include:

  • Wanting to die.
  • Conviction that he or she cannot be helped.
  • Feelings of absolute worthlessness.
  • Sudden change in sleep patterns.
  • Sudden change in eating patterns.
  • Giving away prized possessions.
  • Sudden inability to make even the smallest of decisions.

Symptoms of the depressive phase will differ from patient to patient.

Diagnosing Children

The diagnosis of children with bipolar disorder is a controversial area in mental health circles. For example, in England, a mental health professional will refuse to diagnose anyone with manic depression until they are at least 18 years old. However, in North America, children as young as three or four have been positively diagnosed.

There is no test that anyone can take to find out whether they are bipolar or not. Parents of patients or the patients themselves are asked a long series of questions about their past and how they feel during certain times. Diagnosis is based depending on those answers and if the patient is currently suffering from a manic depressive cycle or manic depressive psychosis.

Causes of Bipolar Disorder

It is unknown what causes bipolar disorder. Since it does seem to run in families, there may be a genetic basis for this serous mental illness. However, having two parents that are bipolar does not guarantee that all of their children will be bipolar (although it certainly ups their chances.) In March of 2014, five gene regions were discovered by a team of international scientists that seems to directly impact bipolarity. Just how this knowledge can be used remains to be seen.

According to the National Institute of Mental Health, structural problems in the brain may also contribute to bipolarity. However, this is not certain, although studies comparing bipolar brains with non-bipolar brains marches onwards.

Types of Bipolar Disorder

There are several types of bipolar disorder, but all are characterized as having a cycle of mania to depression. All types need management by a mental health professional. Medication may be needed. Here is a brief description of some common types, according to WebMD:

  • Bipolar I: the stereotypical bipolar disorder with clearly defined, very dramatic periods of mania and depression which may or may not include manic depressive psychosis.’
  • Bipolar II: this is considered a “milder” form of Bipolar I with harder to determine periods of mania and depression. This is still a serious illness that needs treatment.
  • Cyclothymic disorder: The patient experiences more time being manic and less time depressed as compared to patients suffering from either Bipolar I or Bipolar II.
  • Mixed bipolar: This is when a person simultaneously experiences depression and mania.
  • Rapid cycling bipolar disorder: If a person has four or more full manic-depressive cycles a year, this is called rapid cycling bipolar disorder.
  • Pediatric bipolar affective disorder: If any child exhibits the symptoms of cycling for at least one full week, they may be diagnosed with this type of manic depression. Whether this is any different from the other types in older children and adults remains a point of controversy.

Famous People with Bipolar Disorder

As mentioned before, many celebrities have gone on to have successful careers despite suffering from bipolar disorder. They include:

  • Stephen Fry: best known for his comedy series A Bit of Fry & Laurie, his hosting of the BAFTA awards and for his incredibly large Twitter following.
  • Carrie Fisher: actress and author, best known for her role as Princess Leia in the Star Wars trilogy.
  • Spike Milligan (1918 – 2002): Considered the most influential British comedian of the twentieth century. Best known for being the brains behind the hit comedy radio series The Goon Show, he also acted and wrote prolifically.
  • Jeremy Brett (1933 – 1995): Versatile British actor best known for his role as Sherlock Holmes from 1984 – 1994.
  • Ben Stiller: incredibly successful actor and screenwriter best known for the film Something About Mary. He announced in 1999 that he was bipolar.

Historical figures suspected of suffering from manic depressive disorder include influential novelist Ernest Hemingway (who committed suicide), reformer Florence Nightingale, singer Frank Sinatra, philosopher Frederick Nietzsche and tragic poet Edgar Allan Poe.

Living With a Bipolar Person

It is not easy living with a bipolar person, no matter what age that person might be. Relationships are particularly prone to suffer as the once lovely, ebullient partner suddenly descends into a furious hopelessness. It is important for loved ones and family members of bipolar people recognize the signs of mania or depression so that they can summon help.

Caretakers of people with manic depressive disorder must be tough-skinned. They must argue with their loved ones when they refuse to seek medical help. They must help make sure that their loved ones take their medication and show up for medical appointments. They must get ready for sleepless nights and lots of heartache.

Treatment for bipolar disorder differs for each patient. Some patients may do well without medication, as long as they have at least one person they trust to tell them when to go to the hospital. Medications for bipolar disorder include:

  • Mood stabilizers such as Depakote.
  • Lithium (which requires regular blood tests to prevent lithium poisoning).
  • Anticonvulsants such as topiramate (which is also used as popular migraine medication).
  • Atypical antipsychotics like olanzapine (which is also used for major depression).
  • SSRI antidepressants including one of the most prescribed drugs in the world, fluoxetine (brand name Prozac).

These can be combined with talk therapy which may include cognitive behavior therapy and family therapy to help the patient and the caretakers. Meeting other bipolar patients can help patients realize that they are not freaks, just people suffering with a legitimate illness.

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